{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:17:11Z","timestamp":1777612631261,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2013,10,7]],"date-time":"2013-10-07T00:00:00Z","timestamp":1381104000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2014,1]]},"abstract":"\n Background:<\/jats:title>\n Patient-reported outcomes (PRO) are critical to understanding the value of orthopedic treatments. We hypothesized that use of the computerized adaptive testing from a well-characterized physical function item bank would show superiority in assessing all levels of physical function compared to current standard generic physical function outcomes instruments for foot and ankle patients.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n In a population of 126 foot and ankle patients we compared the psychometric properties for three PROs: the Physical Function subscale of the Medical Outcomes General Health Survey (SF-36 PF) version 2, the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) Computerized Adaptive Test (CAT), and the Lower Extremity (LE) CAT. A Rasch item response theory (IRT) model was applied to assess and compare the fit, dimensionality, reliability, validity, and coverage.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The unexplained variance for the PF CAT was 3.9% and the LE CAT was 2.1%, suggesting each instrument explained a single concept. The SF-36 PF had more concerning unexplained variance of 7.6%. We found no floor or ceiling effects for the PF CAT, a minimal floor effect (1.6%) but no ceiling effect for the LE CAT, and an 11.1% floor effect and 9.5% ceiling effect for the SF-36 PF.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Foot and ankle clinicians and researchers interested in measuring patient perceived functional outcomes with a generic instrument should consider using either the PF CAT or the LE CAT rather than the SF-36 PF. Further studies comparing these CATs to anatomic specific instruments are needed.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n Level I, diagnostic study.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/1071100713507905","type":"journal-article","created":{"date-parts":[[2013,10,7]],"date-time":"2013-10-07T23:17:56Z","timestamp":1381187876000},"page":"1-7","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":85,"title":["Time for a Paradigm Shift With Computerized Adaptive Testing of General Physical Function Outcomes Measurements"],"prefix":"10.1177","volume":"35","author":[{"given":"Man","family":"Hung","sequence":"first","affiliation":[{"name":"University of Utah School of Medicine, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy D.","family":"Franklin","sequence":"additional","affiliation":[{"name":"University of Utah College of Education, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley D.","family":"Hon","sequence":"additional","affiliation":[{"name":"University of Utah College of Engineering, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Cheng","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jillian","family":"Conrad","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles L.","family":"Saltzman","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine, Salt Lake City, UT, 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